The United States is currently experiencing drug abuse at levels never before seen. According to the Center for Disease Control (CDC) drug abuse has increased over 100% in the last half-decade. In particular, prescription drug abuse is on the rise, and so are overdose fatalities.

Having stated that, there are definite legitimate reasons to provide narcotics for chronic pain. In order to provide narcotics safely, most pain clinics are now utilizing urine drug testing to make for a safer treatment.

Below we discuss the top 5 reasons urine drug testing protects both the patient and the Florida pain doctor.

1. Drug testing provides documentation the patient is taking their prescribed medication as well as avoiding illicit drugs.

A drug test provides tangible proof that the patient is taking their medication. It is also a way for the pain doctor in Florida to discover if the patient is abusing illegal drugs such as heroin and methamphetamines. Increasingly there are a number of people obtaining prescriptions then selling them on the black market as a way to earn money.

2. Drug testing helps in the regulation of narcotic prescriptions.

More states are clamping down on narcotic prescriptions because of abuse. That means additional regulations are being implemented such as drug testing. A drug test will soon be the standard for receiving prescription narcotics.

3. Drug testing protects the provider from legal issues.In a litigious society, a drug test administered by a health care provider provides a paper trail protecting the care giver from potential lawsuits. For example, should a patient sell their prescription to someone who in turn injures someone while on the substance, the doctor may be held liable unless there is a trail of documentation protecting him or her.

4. Provides equality for all patients.

It is not necessarily fair for only young people between the ages of 15-24 to be drug tested. Testing patients of all ages makes it a fair playing field, and is safer for everyone. Prescription drug abuse is not just a young person problem. People of all ages are falling prey to drug abuse.

5. Provides a baseline for the patient’s narcotic usage.

A drug test establishes proper care for new or first time patients. It ensures the patient is accurately portraying the drug history they wrote down on the intake application.

The Florida Pain Network connects those in pain with pain clinics throughout Florida. This includes pain management Tampa trusts, Orlando pain clinics, West Palm Beach pain management and many more. Visit the website to find those closest to you or call (877) 877-8556 for assistance today!

At any one point in time, 1% of the US population is suffering from sciatica due to a herniated disc causing a pinched nerve. Having sciatica does not necessarily mean that surgery is going to be necessary, although it may feel as if the pain is so bad one needs it.

What is the right time for surgery for sciatica?
If a person has no problems with bowel or bladder function, and there are no motor deficits and weakness involved, then surgery for sciatica becomes simply a quality-of-life decision. This means that the patient will need to consider how bad the pain is and gauge that versus the relief being obtained from nonoperative treatments.

If the symptoms are simply pain down the leg along with some electrical sensation and pins and needles feeling, then considerable conservative treatment should be trie prior to opting for surgery. In textbooks, the usual advice is to attempt conservative treatment for 6 to 8 weeks prior to considering an operation.

If an individual is dealing with more severe issues, then surgery should be considered sooner. This will include one condition that is a surgical emergency called cauda equina syndrome. In this syndrome, the patient’s spinal cord is being compressed and it can lead to permanent bowel and bladder problems if not addressed right away. While rare, it is a surgical emergency.

Pinched nerve.

Another issue that is important but not an emergency is when an individual does have significant muscle weakness. This may include a foot drop which is difficulty lifting up one’s foot due to a pinched nerve. When this occurs consideration should be given to surgery. It can be watched for 6 to 12 weeks, but it is unclear after that whether or not it will ever improve even if a technically perfect surgery to un-pinche the nerve being compressed.

So with cauda equina syndrome, surgery is mandatory. With motor weakness, surgery should be considered and if the motor weakness is getting worse or not improving over time, then the nerves being pinched should be operated on.

And lastly, if an individual is simply having pain and numbness and is not getting better despite considerable conservative treatment over a 6 to 8 week period, then surgery can be considered as a quality-of-life decision. Studies have shown that while surgery can get patients back to work sooner and out of pain faster with surgery, the end result is the same at one year if surgery can be avoided. So that’s a consideration.

The Florida Pain Network connects those in pain with pain management clinics throughout Florida. This includes pain clinics in Orlando, Tampa pain management clinics, Fort Myers, Port St Lucie and many more. Simply visit THIS PAGE to find clinics close to you or call (877) 877-8556 for assistance.

Fibromyalgia affects between five and 10% of Americans, predominantly women between age 35 and 55. The cause of the condition is not fully known. Typical symptoms include back and neck pain, shoulder discomfort and potentially radiation into both arms and legs.

The quality of the pain experienced includes a deep muscle tenderness along with a feeling of soreness. Patients often have flu like aches along with muscle stiffness and overall fatigue.

Because of the chronic nature of fibromyalgia, individuals may also experience anxiety or depression. Headaches are common along with interrupted sleep. All too often, fibromyalgia is seen in association with irritable bowel syndrome.

Unfortunately, the pain associated with the condition may show up for months at a time And then individuals may experience somewhat of a remission.

The diagnosis of fibromyalgia includes widespread pain that lasts for a minimum of three months, along with pain in at least 11 of 18 tender points throughout the body. There is no true blood test or imaging modality to make the diagnosis. If the person does not meet the criteria for 11 tender points, the condition usually is still treated the same way but it’s called myofascial pain syndrome.

Treatments for fibromyalgia are not a one-size-fits-all situation. Medication management is often extremely helpful which may include muscle relaxants, sleep aids, over-the-counter anti-inflammatories and Tylenol along with membrane stabilizing drugs such as Lyrica.

For periods of acute exacerbation with fibromyalgia, narcotic medications may be helpful. With chronic opiate medications, the risks can start to outweigh the benefits.

These treatments need to be individualized to the patient’s symptoms along with their tolerance for their inclusion. For instance, some patients of fibromyalgia are unable to tolerate massage and acupuncture.

Pain management clinics in Florida offer great treatments for fibromyalgia, and quite a few are in the Florida Pain Network. National Pain Institute offers IV therapy which has been shown to offer significant relief with low risk.

It’s no secret that narcotic prescriptions have risen dramatically over the last decade. In fact, prescriptions for narcotics increased over threefold between 2000 and 2010. Along with that, narcotic prescription abuse has increased exponentially, with over 15,000 overdose fatalities occurring annually now in the US.

A recent statistic reported in the LA Times also showed that over 30 times that amount, or close to half a million, overdoses occur annually that did not result in fatalities but trips to the emergency rooms around the country.

Prescribing narcotics is a risky business, and pain clinics in Florida often incorporate numerous safety mechanisms into their practice to help prevent adverse event’s from occurring.

Some of these safety mechanisms actually involve treatment offerings to help decrease the amount of narcotics being prescribed. For instance, a lot of Florida pain doctors offer interventional treatments such as epidural injections, radiofrequency ablation, spinal cord stimulation therapy and many more to help decrease the amount of narcotic medications necessary to achieve adequate pain relief.

Along with these offerings, comprehensive pain clinics often incorporate physical therapy, acupuncture, chiropractic treatment, massage and more to help either decrease the meta-pain medications necessary or prevent the person from needing more and more.

Monitoring aspects help to level the playing field between those patients who take their medications inappropriately or sell them versus the majority of patients who actually take their medications as prescribed.

One of these mechanisms is urine drug screening. Patients do not like to be drug tested, and some get very upset about it. It should not be viewed as a personal affront to the patient. Studies have shown that over 30% of patients have abnormal findings on drug screens including illicit drugs or their medications do not show up in the screen.

This occurs across all patients, not just those in the inner city. Urine drug screening is a vital part of facilitating patient compliance in their medication management, preventing illicit drug use, and helping bolster liability concerns for the physicians practice.

Another mechanism often utilized by pain practices is a state prescription database monitoring. Over half of the states have this in place, and it is often able to detect if a person is receiving narcotics from numerous doctors. While it is not foolproof, it can in fact help deter patients from obtaining narcotics from multiple sources.

The third way that pain doctors increase patient compliance with treatment regimens is with opioid agreements. Sometimes these are termed opioid contracts, and essentially put in writing the expectations for the patient with regards to their narcotic treatment.

It lays out that the patient is only going to receive narcotics from one Florida pain management doctor, will take medications as prescribed, and notify the doctor about loss or theft of medication and other requirements.

Most of the points in the agreement seem to be self-explanatory, but having it in writing overtly says to the patient that he or she can be let go from the practice if they fail to comply.

Prescribing narcotics can dramatically help those with chronic pain, but it is a risky proposition. Therefore, responsible opioid prescribing means pain practices institute mechanisms to place patients on a level playing field in order to effectively treat their pain while minimizing the risk of adverse events.

In the world of pain management, radiofrequency ablation is the most technologically advanced procedure that has come around in decades. not only is it very effective at relieving pain, it can relieve pain for over a year to 18 months until it may become necessary again. One of the main questions asked is what kinds of pain radiofrequency ablation is meant to relieve and is it good for leg pain?

To answer that question, let’s consider the different types of pain that emanate from the back. Back pain that stays simply in the back is usually due to spinal arthritis, which is a pain coming from arthritic facet joints, or pain emanating from a degenerative disc.

These two conditions often cause back pain that waxes and wanes. Pain from these conditions may get referred into the sides of the back, the buttocks, the hip area, or the upper thighs as well. But it does not radiate down into the legs past the knee.

Pain that goes down a person’s legs past the knee is typically due to nerve root compression in the spine.
When a radiofrequency ablation is performed, the effect is to administer heat to nerve endings and to reduce pain. The nerves that are being deadened are not nerve roots, rather, they are tiny nerve endings that are supplying sensation to the joints of the back.

So in effect, radiofrequency ablation is not meant for leg pain that goes below the knee, as that pain as mentioned is most likely coming from a pinched nerve root, which is pain that radiofrequency ablation does not affect.

If a person’s pain is coming from referred pain due to spinal arthritis in the facet joints radiating out into the buttock area or hip area, then a radiofrequency ablation may in fact help considerably.

Epidural steroid injections are best for herniated disc pain.

It is important going into a radiofrequency ablation that the patient understands what type of outcome to expect for the condition that the person has. Sciatica pain from a pinched nerve is better treated with an epidural steroid injection, which places soothing medication around the inflamed nerve root. Heating up the nerve root with radiofrequency ablation would damage that root and it is not indicated.

Pain clinics in Florida are experienced in radiofrequency ablation. Board certified pain doctors know whether the radiofrequency neurotomy is indicated or whether an epidural steroid injection is better. The Florida Pain Network connects those in pain with pain relievers.

** Disclaimer
The Florida Pain Network is not a healthcare provider and does not by itself form patient-physician relationships. It is a directory of medical providers who may be contacted for treatment. The Florida Pain Network cannot guarantee outcomes from being treated by these providers. None of the medical information provided on the site should be construed as individual medical advice or anything other than educational content or a medical provider directory.